Inflammatory aneurysm of the thoracoabdominal aorta with associated dissection.
The inflammatory variant of aortic aneurysms has 3 unique features: marked thickening of the aneurysm wall, fibrosis of the adjacent retroperitoneum, and rigid adherence of the adjacent structures to the anterior aneurysm wall. Abdominal tenderness with or without a pulsatile abdominal mass is the most common finding, although it is present in only about 33% of patients. Systemic symptoms, such as fever, malaise, and weight loss, are reported in about 20% to 50% of patients. A contrast-enhanced computed tomography scan, magnetic resonance imaging, and a transesophageal echocardiogram are among the best modalities to evaluate for inflammatory thoracoabdominal aneurysm, but a transthoracic echocardiogram can frequently be very suggestive. Medical treatment options include corticosteroids or other anti-inflammatory and immunosuppressive therapies. Surgical intervention usually consists of a transperitoneal approach with infrarenal aortic clamping. This case review describes a 64-year-old woman with a history of hypertension and dyslipidemia who presented with anemia, lower back pain, and a recent 30-pound weight loss.
Lather
Navneet
N
Department of Medicine, Columbia University, Harlem Hospital Center, New York, NY, USA.
Alvior
Jonathan
J
Gripaldo
Ria
R
Fergus
Icilma V
IV
D000740:Anemia / Q000209:etiology; D000784:Aortic Dissection / Q000150:complications / Q000473:pathology* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000473:pathology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D050171:Dyslipidemias / Q000150:complications; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D017116:Low Back Pain / Q000209:etiology; D008875:Middle Aged; D013902:Radiography, Thoracic; D012185:Retroperitoneal Fibrosis / Q000150:complications / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015431:Weight Loss